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Insurance Coverage for Telehealth

Several insurance companies have announced support for telehealth services, including WAIVING the patient’s financial share. Expanding telehealth availability, will reduce risk exposure and help prevent the spread of COVID-19. Many payors have announced the waiver of patient responsibility for telehealth, which include: Aetna, BlueCross BlueShield, Cigna, United Healthcare, Anthem, and Humana. Despite these announcements, you should inquire with your insurer directly as coverage varies by plans. Additionally, Vice President Pence recently made an announcement indicating he has secured commitment from insurance companies to cover telehealth services.

As of April 1, 2020, payor guidelines are as follows:

Aetna: Waiving cost sharing for covered telemedicine visits, regardless of diagnosis (related or non-related to COVID-19) until June 4, 2020.

Cigna: Waiving out-of-pocket costs related to screening and assessing COVID-19, members may also receive virtual medical care not related to COVID-19 by physicians and certain providers with virtual care capabilities through May 31, 2020. Out-of-pocket costs may apply.

United Healthcare: Waiving member cost-sharing for treatment of COVID-19 through May 31, 2020 for fully-insured, Commercial, Medicare Advantage and Medicare plans. Beginning March 31, 2020 through June 18, 2020 United Healthcare will waive cost sharing for in-network non-COVID-19 telehealth visits.

Anthem: Effective 90 days from March 17, 2020: Anthem’s affiliated health plans will waive member cost shares for telehealth visits, including visits for mental health and substance use disorders for fully-insured employer plans, individual plans, Medicare and Medicaid plans. Cost sharing will be waived for members using Anthem’s authorized telemedicine service (LiveHealth online) as well as care received from other providers delivering virtual care through internet video and audio services. Self-insured plan sponsors may opt out of this program.

Humana: Effective March 10, 2020 for 90 days: Humana will waive members out-of-pocket costs for telemedicine visits when participating with in-network providers for routine visits for primary and specialty care. Telehealth visits will be fully covered. Either video or phone visits will be covered for routine visits or specialty care visits.